37 Asian Pacific Journal of Cancer Care• Vol 5• Issue 1 apjcc.waocp.com Ng Chong Guan, et al: ‘5 Minutes Mindful Breathing’ Smartphone Application for Reduction of Perceived Distress: Introduction Cancer is one of the most common chronic diseases globally, with its incidence and mortality rapidly growing. In 2018 alone, there were 18.1 million predicted new cancer cases and 9.6 million cancer-related deaths [1]. Due in part to intense treatments, heavy economic burden as well as comorbidities, chronic diseases including and especially cancer bring with them an additional increased risk of poor mental health [2-3]. The National Comprehensive Cancer Network [4] defines cancer-related distress as a “multifactorial unpleasant emotional Abstract Background: We have found our 5-minute mindful breathing technique to be effective in reducing distress in palliative cancer patients. As palliative cancer patients tend to experience high levels of distress, the integration of this technique into a smartphone-based application could be a viable intervention option for these patients as well as their caregivers. Objective: We aim to further examine the efficacy of our mindful breathing module on distress reduction within the context of a smartphone-based application for palliative cancer patients and caregivers over a seven day period. We hypothesized that the intervention group (access to mindful breathing module) would have significantly greater distress regulation than the control group (access to soothing music) over seven days of using the smartphone-based application. Methods: 35 subjects were recruited from the palliative care ward at University Malaya Medical Centre (UMMC) and randomly assigned to either the control (access to soothing music) or intervention (access to mindful breathing module) group respectively. They then used and followed instructions as per the smartphone-based application for seven days. Results: While both groups reported a reduction in distress in using the application, there was no significant difference in reported distress levels between those who had access to the mindful breathing module and those who had access to only soothing music over the seven days. Our hypothesis was not supported. Conclusion: Although not significantly greater than the control group, the intervention group reported a reduction in distress using the smartphone application, which suggests that the integration of mindfulness and smartphone applications could potentially play a role in future distress reduction for patients and caregivers in view of its accessibility, ease of administration and anonymity. Keywords: Cancer- mindfulness- smartphone application- distress reduction DOI:10.31557/APJCC.2020.5.1.37 ‘5 Minutes Mindful Breathing’ Smartphone Application for Reduction of Perceived Distress: A Pilot Study Ng Chong Guan 1 , Tan Seng Beng 2 , Melvyn Zhang 3 , Roger Ho 4 , Low Sue-Yin 5 , Ng Yit Han 6 experience of a psychological (cognitive, behavioural, emotional), social and/or spiritual nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment”. Psychological distress is a broad construct, encompassing common emotions such as sadness, vulnerability, and fear as well as more debilitating issues such as clinical depression and intense anxiety. Heightened psychological distress in patients with cancer is often associated with negative outcomes such as lesser treatment adherence [5], higher mortality risk [6-7], and poorer quality of life for both patients as well as their caregivers [8-9]. Consequently, the 1 Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Malaysia. 2 Department of Medicine, Faculty of Medicine University of Malaya, Malaysia. 3 Institute of Mental Health, Singapore, Malaysia. 4 Department of Psychological Medicine, National University of Singapore, Singapore, Malaysia. 5 University Malaya Medical Centre, Malaysia. 6 Department of Social Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia. Corresponding Author: Dr. Ng Chong Guan Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Malaysia. Email: chong_guan@um.edu.my RESEARCH ARTICLE Asian Pac J Cancer Care, 5 (1), 37-43 Submission Date: 11/19/2019 Acceptance Date: 01/14/2020